Individual provider Active NPI

Kristen Elizabeth Krueger, P.A.

  • Medical Physician Assistant
  • West Bloomfield, MI
National Provider Identifier
1891800769
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
5601004286 Issued in MI
Practice address
2300 Haggerty Rd
Suite 1010
West Bloomfield, MI 48323-2184
Phone
(248) 668-0900
Fax
(248) 926-9112
NPI assigned
Aug 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 5601004286 MI Primary

Addresses

Primary practice location

2300 Haggerty Rd
Suite 1010
West Bloomfield, MI 48323-2184

Mailing address

2300 Haggerty Rd
Suite 1010
West Bloomfield, MI 48323-2184
Phone (248) 668-0900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041123000065 MI Practitioner - Physician Assistant 3779548433 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lawrence M Dell, MD, PCGroup PAC ID 1456398775, 6 clinicians

Practice addresses (Care Compare)

2300 Haggerty Rd
West Bloomfield, MI 48323-2185
Phone (248) 668-0900

Hospital & facility affiliations

  • Henry Ford Health West Bloomfield Hospital Hospital, W Bloomfield, MI, CCN 230302
  • Beaumont Hospital Royal Oak Hospital, Royal Oak, MI, CCN 230130
  • Huron Valley-Sinai Hospital Hospital, Commerce Township, MI, CCN 230277

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5601004286MIMDMedical Physician Assistant

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891800769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 HAGGERTY RD",
            "address_2": "SUITE 1010",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483232184",
            "telephone_number": "248-668-0900",
            "fax_number": "248-926-9112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 HAGGERTY RD",
            "address_2": "SUITE 1010",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483232184",
            "telephone_number": "248-668-0900",
            "fax_number": "248-926-9112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUEGER",
        "first_name": "KRISTEN",
        "middle_name": "ELIZABETH",
        "credential": "P.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601004286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bloomfield, MI

Sources for this page

Verify at the official NPI Registry.